Racial and ethnic variations of electrocardiographic and echocardiographic indices in female athletes: a meta-analysis
Bibliographic record
Abstract
Abstract Background Although it is well known that high-intensity physical training can induce structural changes to the heart, most of the published data concern male athletes only. There remains a paucity of knowledge concerning the potential racial and ethnic variations of the female athlete’s heart. Purpose We aim to compare markers of cardiac function and structure among female athletes of different races and ethnicities, and to provide reference values specific to each group. Methods We searched Embase, PubMed, MEDLINE, CINAHL and Google Scholar. The inclusion criteria were: (1) adult females (≥18 years old), (2) athletes (registered in a sports federation who engage in sports most days for several hours), (3) reported data about race and ethnicity, and (4) reported data on echocardiographic and/or electrocardiographic indices. We excluded studies with female master athletes (≥35 years old) and studies with athletes who had known cardiovascular disorders at the time of study entry. Results We included 43 cohort studies, enrolling 13,862 female athletes, of which 7,066 were endurance, 298 were resistance and 6,498 were mixed athletes. The median age was 22.2 (95% CI: 21.1, 23.3) years old. We presented the results in Table 1. Although no differences were statistically significant, Black athletes had the highest systolic blood pressure (110.9 mmHg), while White athletes had the highest diastolic blood pressure (71.1 mmHg). The mean heart rate was lowest in White athletes (55.2/min) and highest in Hispanic athletes (68.8/min). Moreover, QRS duration was shortest in Black athletes (83.7 ms) and longest in Metis athletes (90.0 ms), while QTc duration was shortest in Hispanic athletes (408.0 ms) and longest in Pacific Islander athletes (423.3 ms). The indexed left ventricular mass was highest in Black athletes (85.6 gm/m²) and smallest in Asian athletes (65.6 gm/m²). Finally, the indexed atrial volumes were highest among Black athletes, with the indexed left atrial volume at 32.8 mL/m² and the indexed right atrial volume at 25.8 mL/m², respectively. Conclusion Due to the small number of studies of races and ethnicities other than Whites, we were insufficiently powered to detect significant racial and ethnic variations in female athletes' hearts. However, our findings may serve as normal reference values for cardiologists and healthcare providers who wish to better interpret electrocardiographic and echocardiographic findings in their female athlete patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.004 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".